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Killer Fungi
Transition–what about fungus in medical history? We are a historical podcast after all Historical Fungus Story–even one damn fungus caused a bunch of trouble (claviceps purpura), or does it? Ergot and Salem
Transition: ergotism does cause a long-standing medieval affliction called St. Anthony’s Fire, which spawned a whole hospital system run by monks
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Aaron Silver Fox Doc
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On the heels of our case discussion in the prior Princess Diana episode, we’d like to discuss another famous medical case having received lots of good feedback on that episode. So let’s talk about another case–one that involves a personal hero of mine, Erich Weisz. You may know him as the one and only Harry Houdini. I’m curious, without prompting, do either of you know how Houdini died? Many people know Houdini as a magician and escape artist. He was very much those things. But Houdini was also a world renowned debunker. With his vast knowledge of designing and performing illusions, Houdini was especially adept at confronting and exposing psychics and spiritualists who, popular as they were at the time, would take money in exchange for pretending to contact a person’s family members or other loved ones. He was on a personal crusade against this practice as he saw it as fraudulent and predatory. A full re-telling of Houdini’s life is beyond the scope of this medical history show, but I’ll do a brief summary here to set the scene. He was born Erich Weisz in Budapest, Hungary in 1874. His father was a Rabbi and the family moved to the U.S. on July 3rd, 1878 and landed in, of all places, Appleton, Wisconsin! He later moved with his family to good ol’ Milwaukee. As a child, a young Erik Weiss saw a magician named “The Bloodless Vivisectionist” at the “Dime Museum”, described as a “lurid theater” on Wisconsin Avenue. This place sounds absolutely fascinating by the way. The magician used knives to appear to dismember a volunteer from the audience in front of a live crowd before using a flourish to end the show and replace his victims' apparently amputated appendages. A young Houdini was hooked on magic as his future career. I only wish my own career origin story was half that interesting. Erich is pursuing his dream of professional magicianship (totally a word) and starts calling himself “Harry Houdini'' after reading the biography of Jean-Eugene Robert-Houdin in 1890. I’m going to gloss over a lot of his life but it’s good to appreciate that Houdini was far from successful when he started. He was apparently okay at sleight-of-hand stuff but not exceptionally gifted. He could, however, escape from a pair of handcuffs and his break came in 1899 when he impressed a manager named Martin Beck in St. Paul, Minnesota by doing so. As he focused on creating and performing more and more dangerous escape acts, his popularity skyrocketed him to eventual international fame. His escapes were truly incredible. Some of the more notable ones included the water torture cell where he would be suspended by locked manacles head down into a sealed water chamber, having to escape out. He did an escape from a nailed and rope tied packing crate after it was tossed into NYC’s east river. He had handcuffs and leg-irons on for that one and the thing was weighed down with 200lbs of lead. Took him 57 seconds to get out, apparently leaving the crate intact with the manacles inside. And, of course, there were his buried alive stunts where he would be, well, buried alive and have to escape in front of the crowd. In Santa Ana, California in 1915, on his first attempt at this trick, he almost died. He panicked and was trying to dig his way to the surface, collapsing just as he broke his hand through and had to be pulled from his grave by assistants. To be clear, these were acts, but they were very dangerous and more than a few magicians have died trying to reproduce Houdini’s escapes. The other fascinating part of his career was as an incredible debunker of mystics. Houdini, though he could make people believe in the impossibility of his spectacles, was an ardent skeptic and in his later career would go on to make spectacles of exposing so-called psychics and mediums. There is so much more to this part of the story that I’ll leave alone, lest I be distracted away from the medical history of this story, but I would encourage everyone to do their own deep dive on Houdini. With that all being said, let’s get to the medical case. Among all of his death defying escape acts and professional psychic busting, Houdini had a bit he would do where he would challenge people to punch him in the stomach. If you’ve ever seen pictures of Houdini you’d appreciate that he was, medically speaking, jacked. Especially for the time, Houdini had a strong physique and this included a set of abs able to withstand punches–if he was prepared. In Montreal, Canada, on Oct 22nd, 1926, Houdini was backstage prior to his performance that night, kicking back on a couch. He was in the company of three local medical students from McGill University, which has been mentioned more than once on this show. He’s lying on the couch because he had apparently broken his ankle in a prior recent performance. The topic of his ability to withstand punches to the abdomen comes up and one of the medical students named Gordon Whitehead asks if it’s true that Houdini can’t be hurt by gut punches. Houdini says it’s true and either invites Whitehead to try or Whitehead just assumes he can give it a go. While Houdini reclined on the couch with a broken ankle, Whitehead delivered “some very hammer-like blows below the belt” well before Houdini’s abs could be tightened. Below the belt means lower abdomen in this context, FYI. Belts were just higher back then. Houdini is described as appearing to be in significant pain after this, has Whitehead stop and manages to carry on with his performance. He spends two days in constant pain but travels from Montreal to Detroit, Michigan on Oct 24th, 1926 for his next scheduled show. As his abdominal pain is not improving and severe, he goes to a doctor before that performance and is apparently told he needs immediate surgery on his abdomen. He has a fever of 102 degrees at that time. He politely declines and goes to the Garrick Theater in Detroit to carry on with his performance. By the time he takes the stage, his fever is up to 104 degrees but even this does not stop him. He is described as ill-appearing and making uncharacteristic mistakes during the performance. One account even has him passing out and being revived prior to ending the show. He makes it through the show and returns to seek medical attention at Detroit’s Grace Hospital. He is admitted to the hospital with fever and abdominal pain and, for reasons not entirely clear to me, days go by until he undergoes an operation. Upon opening his abdomen they find he has diffuse peritonitis (describe) from what appears to be acute perforated appendicitis. The surgeon does a wash out and Houdini survives for the time being. He apparently is still spiking fevers so days later he returns to the operating room for a second washout of his abdomen. Unfortunately this does not help and on Oct 31st, Halloween, 1926, Houdini dies from sepsis and overwhelming infection at age 52. It wasn’t a magic trick gone wrong. It was a common diagnosis that ended his life. But while appendicitis is common enough, I think you guys will agree that this is a really unusual story for this, correct? Let’s talk about the way appendicitis should work to highlight why this is strange and see if we can explain this. I think it’s fair to say most listening to this show have heard of appendicitis. I’ll go ahead and guarantee that more than a few of our listeners have experienced this diagnosis and are living perfectly normal lives without their appendix at this very moment. The appendix is a noodly appendage of sorts that hangs off of the first part of your large intestine, called the cecum, in the right lower part of your abdomen. It’s typically about the size of an average pinky finger and is a meaty hollow tube with a closed end and an open end where it attaches to the large intestine. Appendicitis happens when material (read poo) plugs up the opening to the appendix causing it to close off and become inflamed with bacteria. It swells up, becomes painful and, if left unchecked, will expand with infection to the point it falls apart or “ruptures” causing bacteria and pus to spill into the inside of your abdomen, causing rampant inflammation of the lining of the abdomen which is called peritonitis. The pus and bacteria, if still left unchecked, will work their way into the bloodstream and overwhelming infection and its ill effects on the human body–something we call sepsis–ensue until death. Today we perform surgery promptly to try and remove the swollen/infected appendix before it ruptures as we know people can live without it. But there is a reasonable question to ask before you remove a part of the body–what does it do? Good question. This is an area of some debate. We are not the only creature to have an appendix suggesting there is or may have been some useful function served. While there is a camp that believes the appendix is a purely vestigial organ–one that is no longer used thanks to the tides of evolution–there is an emerging camp of research that suggests the appendix may be a healthy bacteria storage unit for the large intestine, keeping and harboring bacteria helpful to the functions of the large intestine. There is a third camp of cynics that proposed that the appendix exists only to provide college funding for the children of surgeons. As neat as all that may be, it does stand that people can live perfectly normal lives without this colonic danger noodle. A neat offshoot of researching this case was finding out a bit about the history of the appendix and diagnosis and treatment of appendicitis. Let’s talk about that for a bit and we’ll return to Houdini’s death. Appendicitis has been around–like many things–for ever. As long as there have been appendixes there have been appendicitiseses. One article I’d reviewed recalled the example of an Egyptian mummy that was opened to discover scar tissue and evidence of peritonitis in the right lower abdomen suggestive of appendicitis. But it took awhile to coin the name of this diagnosis. Surely there were many cases of people likely dying from this intra-abdominal infection over the past thousands of years, but it took some time not only to identify the appendix as the cause, but also just to identify the appendix as a structure at all. You might say that much like Houdini, the appendix escaped the attention of anatomists and surgeons for hundreds of years. It certainly escaped Galen’s attention. You might remember him as the famous Greek physician that couldn’t perform dissections due to cultural norms of the time and therefore made up a bunch of nonsense about medicine that was followed as gospel for over a thousand years. He did mention a condition causing right lower quadrant pain and subsequent illness but never mentioned the appendix as a structure of note–though he did do dissections of gorillas and whatnot. In ancient times, medical texts would describe cases of what we now know to be advanced appendicitis wherein the abscess (think boil) that formed inside the person’s abdomen could, at times, grow to poke through the abdominal wall, draining to the outside. I can only imagine how astonishing it would have been for people to just start expelling pus from their abdomen which was now open to the outside world in this case. People did, sometimes, survive when that happened because the infection essentially escaped, but much of the time, as one surgical history article put it, they would “die a peaceful death” from sepsis. I feel like “peaceful” is doing a lot of lifting in that sentence. By the Renaissance period, at least the appendix was being named as its own structure. First descriptions of appendix appear in the late 15th, early 16th centuries. Before he was swinging around katanas and eating pizza, Leonardo Da Vinci drew an appendix among his anatomy drawings in 1492 though it was not published until the 18th century and Da Vinci did not give it a distinct name. Berengario Da Carpi, a professor of surgery at Pavia and Bologna, Italy in 1522 was the first to give the appendix some sort of name. Andreas Vesalius, who has been mentioned before in a few episodes, in 1543 illustrated the appendix in his work “De Humani Corporis Fabrica”, but called it “the cecum” and helped confuse terminology for a while to come. In other words, though he illustrated it, he felt it was just a part of the large intestine and not its own sovereign anatomical structure. I’ve included a picture here in the notes for my co-hosts and will include it on our website with show notes. Moving ahead to the Age of Enlightenment, we have the appendix not only verified as a thing, but physicians and surgeons start to question its function. They still haven’t, at that time, realized that the appendix is a source for the abdominal infections they’d see from time to time. In 1735, a surgeon by the name of Claudius Amyand is credited with performing the first appendectomy–albeit the story is strange and it’s not as if he did the surgery trying to remove the appendix. He performed a surgery on an 11 year old who had developed a painful inguinal hernia. This is where a portion of the intestines escapes the abdominal wall and, as is often the case in males, slithers down the groin to get stuck in the scrotum. It just so happens that the hernia here involved the cecum and attached, inflamed appendix which Amyand removed successfully. A hernia containing the appendix is still called an Amyand’s hernia if you’ve ever heard the term. Basically, he cured a case of appendicitis by doing surgery for another reason. We call this failing correctly. By the late 18th century, famous surgeons like John Hunter of England were describing case after case of right lower quadrant intra-abdominal abscess and even abscess surrounding the appendix, but they still were not connecting the fact that the appendix itself was the cause of these infections. In the 19th century we start connecting the dots. Here come some big-time name drops–at least for medical history nerds. In the early 19th century, Dr. Baron Guillaume Dupuytren–a leading surgeon at the Hotel Dieu’ in Paris–associated right lower quadrant inflammation/abscess with “cecal pathology”, meaning he realized it was starting at that part of the large intestine where one finds the appendix. This was echoed in a graduation thesis published in 1830 by Dr. Goldbeck called “Inflammation in the Right Iliac Fossa” which described all the signs of appendicitis but attributed it to arising from the large intestine, not the little wormy-looking appendix. So close. In 1848, a surgeon named Dr. Hancock performed abdominal surgery with the then new-fangled chloroform anesthetic, draining an abscess that had formed around the appendix, but before it had grown large enough to poke through the abdominal wall and drain to the outside. Almost 20 years after that, in 1867, Dr. Willard Parker writes about four cases of peri-appendiceal abscess drainage–purposefully waiting a few days for symptoms to develop, but trying to do surgery before the abscess inside the abdomen had grown large. This starts the thinking that treatment for appendicitis may be earlier and earlier surgical intervention which definitely did improve the mortality of this illness. Finally, in 1886, a Harvard pathologist named Dr. Reginald Herber Fitz presented a paper to the American Association of Physicians called “Perforating Inflammation of the Veriform Appendix” and he said plainly that the cause of most right lower quadrant inflammatory abdominal disease is perforated appendicitis. He also recommended the appendix be removed prior to becoming an abscess when the diagnosis is suspected and this is still the standard of care today. The year after, in 1887, Dr. Thomas Morton performs the first successful operation deliberately to treat the now titled diagnosis of “appendicitis”. He had been treating a 26 year old male patient who he ultimately took to the operating room after a week of calomel, soda water, stimulants, quinine, warm compresses, and good ol’ fashioned medical leeches failed to treat the appendicitis. He opens the abdomen, finds an abscess around the appendix, cleaned out the pus and removed the appendix as well. He irrigates (washes) out the abdomen and the patient recovers well. Regarding this operation, a contemporary of his named Dr. Chapman wrote about the case and gave his thoughts on the manner of whether or not this little organ should be removed: “A true veriform appendix is found only in six animals: man, gorilla, chimpanzee, orangutan, gibbon and wombat. There can be no doubt, therefore, that the cecal appendix is one of the parts of the human body having no particular function of significance, being of use only in animals… In the human being it ought to be removed with no bad effect whatsoever, so that I thoroughly agree with Dr. Morton in what he has to say regarding the opening of the abdomen and taking out the appendix. It seems to me that the human being is better off without the appendix than with it, for it is nothing but a trap to catch cherry stones and other foreign bodies.” I feel compelled to mention that Dr. Morton’s brother and his son both died of appendicitis prior to this. The last name drop prior to returning to Houdini’s case is that of the surgeon, Dr. Charles McBurney, a US surgeon who, in 1889, described the classic case of appendicitis we all learn as physicians. Pain starts typically around the umbilicus which intensifies and moves to the right lower quadrant as the appendix becomes more inflamed and touches the abdominal wall, accompanied by nausea, vomiting, unwillingness to eat and fever. Though this is how the textbook teaches the diagnosis, I think I’ve seen this exact presentation 2-3 times in the probably 100+ times I’ve diagnosed appendicitis over the last 10 years. Is this your experience as well, gentlemen? So with that classic but uncommon story for appendicitis in mind, let’s return to Houdini. It’s 1926 and he shows up to the hospital in Detroit with a fever and a concerning lower abdominal exam. I don’t think any of us would hesitate to make this diagnosis given those findings. You see that patient, get some bloodwork, and you call the surgeon with your classic exam. Your surgeon invariably agrees with your suspicion and asks for a CT scan anyway. The scan confirms appendicitis and can tell us whether or not the appendix has ruptured. We put the patient on IV antibiotics and they go to an operating room urgently to have the appendix removed. If it is ruptured, the pus is cleaned out and antibiotics are continued to quell any worsening of the infection. In Houdini’s time, antibiotics had yet to be discovered so that wasn’t an option. In uncomplicated cases, patients may be discharged the next day. While they used to do a large incision in the right lower quadrant for this, nowadays a tiny pair of incisions is made and laparoscopic tools are used to remove the appendix and minimize wounds to the abdomen, allowing a really speedy recovery when all goes well. It’s good to be in the modern age. I think the interesting question in Houdini’s death is what about the punches to the abdomen? Did they have anything to do with this final diagnosis? What do you guys think? There appears to be two main schools of thought on this matter. One is that Houdini, being the consummate showman and performer, may have developed the early signs of appendicitis but minimized the symptoms, rendering the punching of the abdomen as a red herring that had nothing to do with it. He carried on with his performance until his symptoms advanced to the stage that he presented with ruptured appendicitis. Whether this is the case, it should be noted that his final performance in Detroit was likely done with a ruptured appendix. That is some pain tolerance. I can’t know for sure, but after researching this episode, I actually think there is plausibility that the punches to the abdomen did have something to do with this. Looking through multiple sources for medical case reports I discovered numerous reports of trauma associated appendicitis. In reading these, it seems that direct trauma to the lower abdomen, if able to strike and compress the appendix or adjacent large intestine, can cause perforation, thus allowing the colon bacteria to escape and start inflaming the appendix. This progresses to appendicitis but appears to start because of the trauma. One systematic review of the literature found 28 cases of trauma induced appendicitis from 1991 - 2009 (various causes of trauma–falls, MVC, strike to abdomen). One of the most fun case reports I found of this was a case of traumatic appendicitis thanks to a well-delivered camel kick. I cite this as my favorite evidence to support the claim that Houdini had trauma induced appendicitis. I will link this in the show notes, of course. Well, that’s the story of the unfortunate end of Houdini and the history of appendicitis. Were you guys not entertained? Sources: -https://www.thehistoryreader.com/historical-figures/death-escape-artist-harry-houdini-appendicitis-surgery/ -https://cbc.org.br/wp-content/uploads/2014/02/02012014-AS.pdf -https://en.wikipedia.org/wiki/Harry_Houdini#Death -https://pubmed.ncbi.nlm.nih.gov/28673696/ (Appendicitis due to MVC) -https://www.hindawi.com/journals/cris/2021/6667873/ (Appendicitis due to camel kick) -https://pubmed.ncbi.nlm.nih.gov/20513274/ (Systemic review of traumatic appendicitis cases)  "The She Wolves of Jülich", 1591. Image from Wikipedia. Many have heard about the infamous European witch trials that ironically took place during a time period we call the Renaissance (c.1450-1750). What you may be less familiar with were so-called werewolf trials, in which physicians of the day would play a part. When a person might be accused of being a werewolf, a physician or similarly identified medical expert of the time might be called into the trial to perform a physical examination to look for evidence of a “connection with the devil,” be it a skin mark or something that could erroneously be used against the defendant–whether they were accused of witchcraft or being a werewolf. Contemporary accounts from this time period describe a possible association between mental illness and the belief that one might be a werewolf. Numerous accounts exist describing individuals (even up to the 20th century) that may have expressed a belief that they were wolves, though these accounts are not necessarily suggestive of violent behavior but may include behaviors mimicking those of a wolf. The term for persons diagnosed with a psychiatric syndrome leading them to believe or act as if they are a wolf is called “clinical lycanthropy” and is thought to be very rare. The medical experts that were called upon to weigh-in on werewolf trials would help render an opinion as to whether the person on trial might actually be a werewolf or, more helpfully, might argue a type of insanity defense that attributed the person’s behavior with a mental illness, which could lead to an acquittal. I think we can all agree that court proceedings and medico-legal defense strategies make for dry werewolf fiction. Predatory, full-moon transforming, silver-bullet dodging lycanthropes may be more interesting in their fictional form. Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4090416/#R37 Max Doctor with a mustache. As we found in our recent episode, the medical origin story of the zombie seems to have originated in Haiti and associated Caribbean islands with practitioners of voodoo, a religious practice brought to the region by West African slaves, and has nothing to do with the flesh-eating, brains-seeking versions in popular culture. Travelers from the Caribbean during the 19th and 20th centuries told tales about persons who were transformed into living dead servants by evilly dispositioned “bokor,” voodoo practitioners believed to have the capability of creating zombies with special brews or potions. The zombie powders obtained from bokors seemed to always contain ground up puffer fish. This, in turn, contains tetrodotoxin, a substance within the pufferfish capable of causing full paralysis–including breathing–in high enough doses. It appears these powders were typically applied to the skin. Cases of persons claiming to have been declared dead only to be found on the streets years later with personality alterations have persisted into the 20th century. This has led to the theory that use of zombie powder may have induced a level of paralysis that appeared to medical practitioners of the time as consistent with death. Persons may have even been buried for a short time until the tetrodotoxin wore off. If they weren’t buried, they also may not have been breathing adequately if the toxin dose paralyzed the muscles of breathing. These factors may have lead to near asphyxiation and the low oxygen environment of a grave may have contributed to varying degrees of anoxic brain injury, a phenomenon that might explain why some of those purported to be zombies, seemed to be acting off or at least without the mental faculties that their families may have expected. This is all a far cry from the pop culture zombies we see in the media today. Max Doctor with a mustache. Much of the popular mythos of vampirism draws from Bram Stoker’s “Dracula,” a work written after he had done a deep dive on the European folklore of the time on the subject of vampires. Though medical conditions such as rabies, porphyria, and tuberculosis have been suggested as culprits in originating the myth of the vampire, a nutritional deficiency may have been to blame: pellagra. Pellagra occurs when people don’t get enough vitamin B3 (aka niacin). This vitamin is used for many cellular functions. We don’t absorb it well from corn, which became the main food staple for the peasant’s diet in much of Europe in the 18th century as it was imported from America. Pellagra was first recognized as a disease in 1735 and suspected then to be due to nutritional cause. Pellagra is described by the “four D’s”: dermatitis, diarrhea, dementia, and death. Dermatitis refers to skin inflammation and rash that can occur with exposure to sunlight with pellagra–easy to make that connection to vampires. Without niacin, neurons can degenerate leading to dementia and, curiously, a behavior called “pica”. Pica is the strong craving for non-food substances including dirt and ice and other unusual things. It’s been suggested that this may result in the apparent unusual cravings of the vampire. Severe pellagra can result in death. Notably, the vampire cannon seems to leave out the diarrhea aspect of this disorder. That’s probably a good thing. Journal Article: https://journals.sagepub.com/doi/pdf/10.1177/014107689709001114 Max Doctor with a mustache. Digitalis In 1785, an English physician, Dr. William Withering, published his account of experimentation with a collection of herbs he’d received from a witch. This stemmed from a patient he’d had who he was treating for “dropsy”, an old tyme term for edema or fluid under the skin, typically attributed to something we know today as congestive heart failure (CHF). Whether it is weakened by a heart attack, a viral infection, or many years of pumping against high blood pressure, a heart may start to pump inefficiently. Instead of moving blood around the body in a nice, orderly fashion, the blood backs up as it fails to move forward as well as it used to. This leads to the fluid part of the blood leaking out into areas like the legs (especially thanks to gravity) and the lungs, leading to the shortness of breath and fatigue that is associated with CHF. So when the 18th century doctor had his patient show up appearing to be improved from a mysterious plant mixture given to him by a supposed witch, the doctor was curious and visited her. He was given a sample of foxglove and pursued testing of it for many years before publishing the account. He gave it to 160 of his own patients with various conditions and noted it seemed to improve the dropsy. He described an active ingredient called digitalis that foxglove and many other plants contain. Today we know this medication as “digoxin” and it is still used to treat CHF in select cases. Digoxin affects the shifting of electrolytes into and out of heart cells with an overall effect of improving the pumping strength of the heart. This helps people move their blood through the kidneys and clear out all that edema. It’s a treatment but not a cure for CHF. Mind you that digoxin can be dangerous in toxic doses. Starting with nausea, poor appetite, and vision problems, high doses can cause kidney issues, dangerous electrolyte levels, and cardiac arrest. Nevertheless, Dr. Withering was keen to listen to the supposed witch in the woods who’d helped his patient and he ultimately helped legitimize–along with others–the use of this seemingly magical medicinal substance. Max Doctor with a mustache. Among the treatments that were recommended by witches (or those who may be accused of witchcraft in Europe dating back to the middle ages), one might find preparations of willow bark and/or leaves. The association between these parts of the willow tree and pain relief were made well beforehand–dating back to perhaps Mesopotamia, the ancient Egyptians, ancient Greeks, and Native Americans, to name a few. Many cultures noted that this plant had seemingly magical properties. Within the leaves and bark of the willow plant (and some others), it contains a type of molecule called a salicylate. By itself, it can decrease inflammation and swelling, thereby aiding in pain relief and decreasing fever. If you’re the type of person who likes to mix chemicals and do reactions, you might have been Felix Hoffman, a German chemist who is ultimately (though with some controversy) credited with combining salicylic acid with acetic acid while he was working at Bayer in 1897. This created acetylsalicylic acid which we know as Aspirin. In this more refined form, that willow derivative functions as a much better anti-swelling and anti-pain medication. It also happens to stop platelets–a portion of the blood that helps form clots–from clumping together. This led to its still continuing role as a cardiovascular medication. If clots aren’t bunching up in narrow arteries, one might expect fewer heart attacks or strokes to occur. Here we have another modern medication with part of its roots in the apothecary cabinet of your friendly, neighborhood medieval witch. Much better than the leeches and purging agents your medieval doctor may have recommended since the willow bark actually worked, after all. Max Doctor with a mustache. Everyone may be familiar with the concept of witches flying about on a broomstick and whatnot. One association between witchcraft and gravity-averse ability came about with the idea of so-called “flying ointments.” These were unguents (new favorite word) or ointments that contained a mixture of different plant materials which had all sorts of interesting potential. There was not a uniform recipe. These ointments might contain varying amounts of plants such as mandrake, henbane, deadly nightshade, and the Socratic favorite, hemlock. Other substances might be mentioned in recipes, including things like opium. One thing in common with the non-opium substances mentioned is that they all contain what are called “tropane alkaloids.” These alkaloids, whether ingested, inhaled, or, in the case of ointments, absorbed through the skin, could certainly make one think they were mid-flight if the doses were high enough. These substances affect the autonomic nervous system–the part of that system responsible for helping regulate the heart rate, pupil size, digestive system activity, increasing or decreasing blood flow to certain areas of the body, controlling one’s bladder, and even regulating the more interesting bodily functions such as sexual intercourse or vomiting. Too many tropane alkaloids and one can find themselves with a racing heart rate, high body temperature, agitation, and, important to the “flying” bit, in a hallucinatory stupor. Death can result as well. The ointments might be applied to certain areas of the skin or coated on a broomstick or similar wooden staff which could be held, allowing the alkaloids to cross the skin into the bloodstream. Cool bit is that many modern medications derive from these alkaloids, including scopolamine (for motion sickness, dizziness), hyocyamine (for abdominal discomfort and diarrhea), and even atropine (speed up slow hearts, reverse certain nerve gas or pesticide toxicity, dilate eyes for the eye doctor). Maybe it wasn’t magic, but it probably seemed close enough given the understanding of the natural world that the 12th-19th century peoples had. Max Doctor with a mustache. When he was standing on the gallows prior to his execution in October of 1892, Dr. Thomas Neill Cream (aka Dr. Neill or the Lambeth Poisoner), a serial killer and poisoner, started his last words with “I am Jack the . . .” and then he was hung for murder in England before he could finish the sentence. Nevertheless this led to speculation that he might have been the infamous Jack the Ripper, and it wasn’t the first time he’d called that name into his legal proceedings. It took way too long to put Dr. Neill away. A year before his execution, an inquest was called by the coroner in the death of Matilda Clover, a 27 year old sex worker that was found dead after a night with Dr. Neill. This was initially dubbed a “natural” death due to alcohol withdrawal. A prominent physician in London, named Dr. William Broadbent, received a letter soon after Matilda’s death stating the writer knew she was murdered by Broadbent and would keep quiet for £25k. Dr. Broadbent was innocent but following the deaths of many other sex workers on Lambeth street, other weathy members of the community were receiving letters accusing them of murder, complete with details of each crime. Hence the coroner called the inquest to re-examine the cause of death. He found it to be strychnine poisoning. Dr. Neill chose to show up at the inquest and produced a letter which he read aloud. It stated that he, Dr. Neill is innocent, and was signed by “Jack the Ripper.” Weird flex since nobody asked Dr. Neill to show up and the letter was obviously a ridiculous forgery. Considering that before all of this, Dr. Neill was imprisoned in Joliet Prison in Illinois, USA during the years of the Ripper killings, it seems unlikely that Dr. Neill, a murderer in his own right, was being truthful with his last words. Go figure. Max Doctor with a mustache.  Strychnine This commonly referenced poison came up in our most recent episode about Thomas Neil Cream, the Lambeth Poisoner. Strychnine is a naturally occurring product in the seeds of the Strychnos nux-vomica plant. Charming name! Initially used as a rodent and bird poison, it’s not surprising that strychnine is very toxic to humans as well. As a poison, strychnine has a peculiar mechanism of action that is similar to how the toxin from the tetanus bacteria works. In the connection between our nerve endings and our muscles (the synaptic gap), when we want to contract a muscle, the chemical acetylcholine is sprinkled from the nerve to the muscle, causing contraction. Other inhibiting substances, such as glycine, are released to help stop muscle contractions. Strychnine stops the inhibiting substances from working, causing uncontrolled muscle contraction in high enough doses. If this happens, one cannot breathe which is the predominant cause of death with this poison. It can also cause metabolic disturbances and muscle breakdown (rhabdomyolysis) as well as seizure-like activity. All that is bad, medically speaking. Though he used other substances, such as chloroform, strychnine was a favorite go-to choice for the late 19th century serial killer/physician, Dr. Thomas Neill Cream. He would either prescribe it under false pretenses or convince people to take it, causing numerous deaths in multiple countries. Image: https://www.wired.com/2012/01/the-science-of-mysteries/ Max Doctor with a mustache. |
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